CIGNA

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Global Knowledge Exchange Network
Overview
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Global Knowledge Exchange Network

• Vision The Global Exchange will become the
  recognized neutral venue for evaluating and
  promoting better practices in achieving
  cost-effective health outcomes from across
  developed and developing nations.
• Mission To improve health and the value of
  healthcare by comparing and contrasting key
  drivers and approaches to addressing healthcare
  costs and outcomes across developed and
  developing nations, with a goal of identifying
  and promoting successful, relevant, and
  replicable strategies.

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GKEN and meeting the global health crisis

• Globally developed and developing nations are
  faced with a health care crisis rising
  healthcare costs threatening system
  sustainability, human resource shortages,
  increasingly frustrated consumers, and an absence
  of shared solutions and cross country
  communications.
• GKEN believes the best way to meet these global
  health changes is Better identification of new
  and emerging better practices Stronger cross
  border and cross cultural promotion and
  dissemination of better healthcare system
  practices utilizing traditional and
  non-traditional channels.

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GKEN Areas of Focus

• Workforce and Training, Governor, Colleen
  Conway-Welch
• Individuals Active Participation in Health,
  Governor, LaMar McGinnis
• Health Promotion and Wellness, Governor, Beverly
  Malone
•  Chronic Illness, Governor, Murray Ross
•  Integration, Governor, Rick Norling
•  Metrics, Governor, Catharina Maulbecker-Armstrong
  
•  Efficiencies, Governor, Shane Solomon
• Health Disparities, Governor, Dominick Stillfried

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GKEN Guiding Principles

• We will focus on emerging, better, and best
  practices with measurable outcomes.
• GKEN is principally a communication initiative
  focused on promoting better healthcare practices
  among developed and developing nations.
• Our ultimate goal is to promote better practices
  across all of the core components of health and
  healthcare
• We believe that improving health systems will
  lead to population health improvements.
• We have a patient/consumer focus.
• We will build on current knowledge and look for
  effective emerging practices. 

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GKEN Guiding Principles (cont)

• We will help enable health systems to promote
  wellness.
• We favor private policy/action (that which can be
  taken by organizations without governmental
  action) over direct influence of public policy
• Our work will be unique and distinctive.
• Our work will be dynamic that is, amenable to
  continuous refinement.

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Developed and developing nations share many of
the same ChallengesFacts on Chronic Disease

• Preventing chronic conditions is a key issue for
  developed and developing countries because of the
  growth and health complexity of the aging
  population, the high cost of treating and
  maintaining the quality of life for those with
  chronic conditions, and the challenges of
  treating chronic conditions in health care
  systems established to treat acute care
  conditions not chronic conditions. Approximately
  half of the burden of disease will be caused by
  chronic diseases, 13 by injuries and 39 by
  communicable diseases, maternal and perinatal
  conditions, and nutritional deficiencies
  combined. Some 45 of chronic disease deaths and
  86 of the burden of chronic diseases occur in
  people under 70 years of age.

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Shared Challenges (cont) Facts of Workforce and
Training

• Costs associated with HR (health resources)
  issues form the single largest expense element in
  any health care system (as much as 60-80 percent
  of total recurrent expenditures depending on the
  country) and are a key factor in reaching health
  care goals (related to quality, access and
  appropriateness of care) in each country .
• The cost of addressing HR issues is only expected
  to increase across countries due to the
  complexity of health care needs of populations
  and training they need in order to address the
  emerging changes in the health care system
  including
• demographic and epidemiological issues (i.e., the
  aging of nations with the number of older people
  soon surpassing the number of young people,
  lifestyle-related morbidity, overall increase in
  multiple, preventable chronic conditions in
  younger productive years, need for health care
  workers to coordinate both health and social
  services)
• impact of new diagnosis and treatment
  technologies as well as the growing demands of
  better educated and informed citizens (i.e.,
  electronic medical records, telemedicine, and
  technical treatment improvements in the delivery
  of care) and
• consequence of increased mobility and migration
  (i.e., internal migration such as from public to
  private sector and rural to urban areas of the
  country as well as international migration),

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Shared Challenges (cont)Facts on Health
Promotion Wellness

• Almost half of all premature deaths in developed
  countries are caused by unhealthy lifestyle
  choices with rates rapidly increasing in
  threshold and poor counties. Health promotion and
  wellness strategies aim to prevent many of these
  deaths and improve quality of life by encouraging
  people to exercise regularly, eat nutritious
  foods, avoid tobacco and excess alcohol, manage
  stress, enhance social networks and economic
  conditions, clarify lifestyle values, and achieve
  a sense of fulfillment in their pursuits.

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The Better Practices Cycle of Adoption 

•  
• The Cycle from Identification to Adoption  
• The challenge for all organizations committed to
  promoting better practices is the incredible lag
  time between when the better practice is
  identified and its actual adoption by the
  healthcare entity.
• Once a better practice has been identified there
  is the further challenge of disseminating that
  information to the appropriate health venues and
  providers. This is a very difficult barrier when
  one looks at the geographic, cultural and social
  obstacles that impede the widespread
  dissemination of better practices.
• The adoption of better practices has proven to be
  and even more challenging issue than the
  challenges of vetting or dissemination. Often,
  years go by before the better practice is
  accepted by the health system or provider despite
  scientific and research analysis that supports
  its efficacy.

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GKEN Communicating the Findings

• GKEN recognizes the critical importance and value
  of disseminating better and best practices
  promoting robust interactive knowledge exchange
  through a variety of media, including printed
  materials, videos/DVDs, seminars, symposiums,
  conferences, toolkits, and a highly user friendly
  public internet site.
• The website will provide detailed information on
  new and emerging healthcare system better
  practices and promote cost-effective healthcare
  improvements to a wide audience across developed
  and developing nations.

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Infection Control Guidelines A Case In-Point of
the Challenges in Gaining the Acceptance of
Better Practices 

• The Better Practice This practice is designed to
  improve infection control in six specific areas
  and was released to the media on October 8th.  
• The Gatekeepers The American Hospital
  Association, the Joint Commission, the Centers
  for Disease Control and the leading international
  epidemiological societies.  
• Length of Time to Adoption The acceptance of
  this better practice has taken years despite the
  fact that many of the guidelines were already in
  existence but there had been no universal
  adoption. In fact, one of the lead authors and a
  renowned epidemiologist found some of the
  guidelines had not been updated in years. Despite
  the critical importance of infection control
  practices there has never been a professional
  consensus on infection control.  
• The Challenge One recent survey found that 87
  of the hospitals did not consistently follow
  infection-control guidelines despite these
  findings being known to the healthcare community
  for a number of years. To quote one expert, To
  often where we fail is not in the knowledge but
  the execution.

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Join the growing GKEN network
Catharina Maulbecker Armstrong , Associate
Partner, McKinsey, Germany Cathy Baase, Global
Director of Health Services, Dow Chemical, US
Russ Bantham, President, Bantham Consulting,
Former General Counsel to PhRMA, US Gordon Best,
Director, OD Partnerships Network, UK Yank
Coble, Professor Director, Center for Global
Health Medical Diplomacy, U. of N. Fla.
Clinical Prof. of Medicine, U. of Fla. Past
President, World Medical Association, US David
M. Cordani, President, CIGNA , US Marty Davis,
Founder President Applied Communications
Institute, Former Dir., Special Campaigns
Promotions, AARP, US Mike Farrar , Chief
Executive, NHS Northwest, UK Pam Garside,
Newhealth, Judge Business School, University of
Cambridge, UK Paul Ginsburg, President, Center
for Studying Health System Change, US Ed Hanway,
Chairman CEO, CIGNA, US Johan Hjertqvist ,
President, Stockholm Network and Health Consumer
Powerhouse, Sweden Maria Hofmarcher-Holzhacker ,
Institute of Advanced Studies France, Austria
Delon Human, Pres., Health Diplomats, Immediate
Past Pres. World Medical Association,
Switzerland Pere Ibern, Professor, Universitat
Pompeu Fabra, Spain Frances Kelleher, VP Market
Intelligence, CIGNA HealthCare, US Wolf Kirsten,
Founder and President of International Health
Consulting Lowell Kruse, CEO, Heartland-Health
Meng Kin LIM, Professor, National University of
Singapore Beverly Malone, CEO, National League
for Nursing, US LaMar McGinnis, Clinical Prof.
of Surgery, Emory Univ. Past Pres., American
Cancer Society, US
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GKEN Network (cont.)

• Chris Mc Swain, Director Global Benefits,
  Whirlpool Corp., US
• Jonathan Meakins, Nuffield Professor of Surgery,
  John Radcliffe Hospital, Oxford UK
• Surya N. Mohapatra, Chairman Chief Executive
  Officer, Quest Diagnostics, Inc. US
• Russ Newman, Provost and Vice President for
  Academic Affairs, Alliant University, US
• Rick Norling, CEO, Premier Inc., US
• Mike O Grady, Sr. Fellow, National Opinion
  Research Center, U. Chicago Principal, O'Grady
  Health Policy, LLC, US
• Stig Pramming, Executive Director of the Oxford
  Alliance
• Jerry Reeves, Principal, Health Innovations LLC
  Chairman, World Doc, US
• Murray Ross, VP, Kaiser Foundation Health Plan
  Director, Kaiser Institute for Health Policy, US
• Barbara Safriet, (former) Assoc. Dean for
  Academic Affairs Lecturer on Law, Yale law
  School, US
• John Seffrin, CEO, American Cancer Society
• Michael Showalter, SVP, HealthCare Strategy
  Marketing, CIGNA HealthCare, US
• Shane Solomon, Chief Executive, Hong Kong
  Hospital Authority, China
• Dominick von Stillfried, Managing Director of
  Zentralinstitut für die kassenärztliche
  Versorgung (ZI), Germany
• Karen Timmons, President and CEO, International
  Joint Commission, US
• Neil Trautwein, Vice President, Natl Retail
  Federation, US
• Janet Trautwein, CEO, Natl Assoc of Health
  Underwriters, US
• Jo Webber , Deputy Policy Director, NHS
  Confederation, UK
• Colleen Conway-Welch, Professor Dean,
  Vanderbilt University, School of Nursing, US